Denial - Not medically necessary - help me appeal

Pam C.
on 4/24/06 12:05 am - Mt Washington, KY
I am so bummed, I finally received a determination from ins - says - not medically nescessary because - this service could not be authorized, the documentation does not appear to include medical clearance, a sleep study, labs and request for cardiology clearance. Anyone who can advise me from here, please do. I don't have an exclusion - just needs to be medically necessary.
sabo
on 4/24/06 12:14 am - Louisville, KY
your doctor should be prescribing all those things for the insurance company. Don't let this bum you out. all you have to do is call your doctors office and let them know you got the letter from the ins co, they will set up all those testings, it takes a few months to get it all done but after that, you'll be scheduled for surgery. I had to go thru the same thing! You'll go thru a sleep apnea test and stuff lke that.
Pam C.
on 4/25/06 2:32 am - Mt Washington, KY
I've already done the sleep apnea test and have severe sleep apnea. This was sent to the insurance company. You know I just don't understand why they just don't do all this 1st and then submit to ins. It would take less time and less frustration. Thanks for your support.
mylilcalla
on 4/25/06 9:43 pm - Bloomington, IN
Melissa, I am so sorry that you are having to deal with all of this. There is nothing that I can think of that would hurt me as much as my partner being unfaithful. You really do need to talk to her about it as soon as possible though. It sounds like things haven't been good for awhile though and you deserve better than this... much better. You are a strong woman. You can and will get through this, not matter what the outcome. Keep your chin off the ground and find a way to make yourself happier. Take good care and know that someone is thinking of you and wishing you nothing but great things. Best, Amy
Erin C.
on 4/26/06 12:03 am - Toledo, OH
I am so sorry it has taken me awhile to respond... our internet has basically been out for almost 2 weeks. I am so sorry you had to find out things the way you did. My thoughts are with you. There is nothing I can say to make things any different, just know that there are those out there that care for you and your happiness. Take care.
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